Provider Demographics
NPI:1285174888
Name:MCCAULEY, SHARON JUNE (LSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:JUNE
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12038 LOCHWOOD ST SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-9791
Mailing Address - Country:US
Mailing Address - Phone:330-639-9337
Mailing Address - Fax:
Practice Address - Street 1:12038 LOCHWOOD ST SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-9791
Practice Address - Country:US
Practice Address - Phone:330-639-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS5510104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker